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Cold Sores On Mouth. Herpes, Igm, Igg Negative. Could Still Be Carrier Without Testing Positive For Igg ?

Posted on Mon, 9 Jul 2012

Question: I have a friend who has cold sores on his mouth from time to time outside on lip and above and has since he was a kid. He had testing done for herpes type 1 and 2 igg blood and tested neg for both. He was testing because he had been with me and I just tested pos to type 2 with a igm and igg typed test how ever I was neg on type 1. And I have had no symptoms.
He is concerned he could be a carrier of both types even tho he test neg with igg. He hasn't had symptoms other than one bump one time that cultured neg beside his privates. Could he be a carrier without testing pos igg? Also on me. I tested pos with 5.something twice about a month apart to igg typed test to type 2 and neg on type 1. Can not get a western blot done right now. I have not had major symptoms. Have had what I thought were yeast infections that could have been this I guess. What are the chances I don't have it and how can I find out if I don't? And since I don't have symptoms how do I know when it is safe to have sex and when it isn't?

Answered by Dr. Sudarshan (4 hours later)

Hi,

Thanks for putting up your query.

I can understand your anxiety.

Diagnosis of herpes infection is done by identifying antibodies to HSV 1 and HSV 2. IgM and IgG antibodies are tested for both type 1 and 2.

IgM positive indicates recent or acute infection.
IgG positive indicates old or past or chronic infection.

As you have tested positive for IgM and IgG, you are definitely infected and can transmit the infection to him in unprotected sex . HSV virus can be transmitted even if person is asymptomatic /has no lesions.
This is known as "asymptomatic shedding".

IgM and IgG are fairly diagnostic of infection. If you want to go for further testing HSV PCR, Immunofluoroscence tests, electron microscopy ,Enzyme immunoassay, Rapid assay are the diagnostic tests.

As far as risk of transmission is concerned, there is small but definite risk of HSV infection to him.

I would suggest you have protected sexual intercourse with him. This is so as virus can be transmitted even in asymptomatic period.

Hope I’ve answered your query. I will be available if you have any further queries.

Take care.
Regards
Dr Sudarshan

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Sudarshan (16 hours later)

On my friend I was concerned about he has cold sores but test neg to herpes 1 with igg test. How is this possible if all cold sores are herpes 1? And if he is one of the rare people that doesn't test pos with igg test for herpes 1 even tho he has it can he also be a carrier of the herpes 2 even tho he test neg with igg? And if so can he then pass on the herpes 2 virus if he is seeing someone else?

Answered by Dr. Sudarshan (5 hours later)

Hi again ,

Herpes IgG may sometimes be negative in presence of cold sores.
This can happen due to low titre of antibodies.
This may rarely happen with Herpes 2 also.
Even if he has tested negative he may be having carrier state of herpes 2.
He can pass on herpes 2 virus even when asymptomatic.

Hope ive answered your query.
If there is anything else you want to ask ,do not hesitate.

Regards.
Dr Sudarshan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudarshan (3 hours later)

is there another way to find out if he is a carrier? Since he is asymptomatic can't do a culture. would western blot show more? what else is there?

Answered by Dr. Sudarshan (7 minutes later)

Hi again,

If you want to go for further testing

1.HSV PCR(polymerase chain reaction), RT PCR
2.Immunofluoroscence tests
3.Electron microscopy
4.Enzyme immunoassay
5.Rapid assay
6. Viral culture
7. Western blot

Hope Ive answered your query.

Regards
Dr XXXXXXX

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar